HomeMy WebLinkAboutPermit Building 1997-6-16
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
SPRINGFIELD
LOCATION OF PROPOSED WORK: "37-::>7
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LOT:
OWNER'
ADDRESS'
CITY:
DESCRIBE WORK:
NEW
REMODEL
CONTRACTOR'S ~
GENERAl' ~/--~
~
PLUMBING'
MECHANICAl'
ELECTRICAl'
BLOCI<"
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STATE:
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JOB NUMBER
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ADDITION
DEMOliSH
OTHER
225 Fiffh Street
Sprlnglleld, Oregon 97477
TAX LOT'
SUBDIVISION:
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PHONE:
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ZIP:
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ADDRESS
CON ST.
CONTRACTOR'
EXPIRES .. PHONE
D Rough Mechanical ~ Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
[El Framing - Prior to cover.
D WallfC'ellfng Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After 1~5tallatlon.
D Insert - After fireplace approva.l
and Installation of unIt.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - Arter
excavation Is compiete, forms
and 'sub-base material In place.
o Fence - When completed.
D Street Trees - When'all required
trees are planted.
- OFFICE USE -
QUAD AREA' LAND USE: FLOOD PLAIN'
. OF BLDGS' . OF UNITS: ZONING CODE:_
OCCY GROUP: CONSTR. TYPE: . OF BDRMS:
. OF STORIES' HEAT SOURCE' SECONDARY HEAT:
WATER HEATER: RANG'" SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769, This Is a 24 hour recording. All Inspections requested before 7:00 a:m. will be
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
D
Final Plumbing - When all
plumbing w9rl< Is complet,e.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
settl~g forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
f";71 Footing - After trenches are
L,Jr;.J excavated.
D Masonry - Steel location, bond
,beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D
Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to.floor
Insulation or decking.
o Floor Insulation - Prior to ~~
decking.
o Sanitary Sewer - Prior to filling
trench.
D ~aorm Sewer - Prior to filling
,trench. .
D Waler Line - Prior to flfIlng
trench.
D Rough Plumbing - Prior to
cover. .
D
Final Electrical - When all
electrJcal work Is complete.
D Final Mechanical - When all
mechanical work Is complete.
fM Final Building - When all
)i::t-J required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blockIng, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o FInal - After all required
Inspections are approved and
,porches, skirting, decks, and
venting have been Installed.
-Y':':1 ': ~":'>"r:;!.1 ~~f.l':~)fr~,)':i;~;,
Lot faces Lot Type~
Lot sq. ftg, Interior RL.
Lot coverage Corner N
, S
Topography Panhandle'
Total height Cul-de-sac W
l-~.
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.BUILDING PERMIT
;it
ITEM
SQ. FT.
X $/SQ. FT. _
VALUE
Main
Garago
Carport
"
'7 5"".0
//.09
-;( ) L.tt>
Toial Value
".'
Building Permit Fee
State Surcharge
~8.5~
t,"?::!
/,/~-
Y/.S"7
;s
Total Fee
'(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
tTEM
FEE
Fixtures
Reslden'tlal Bath(s) N'
Sanitary S~wer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State'Surcharge
Total Charge
, (C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
iD)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
ft
Demolition
Slale Surcharge
Tolal Miscellaneous Permi ts (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
,"~2
Setbacks.
I HSE GAR I Ace'l
I
I
I
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BUILDING VALOE, PLAN CHECK
AND BUILDING PERMIT
j THE PROPOSED WORK oN THE _
HISTOI'lICAL DiSTRICT, OR ON
THE HISTORICA~ REGISTER?
If yes, this application must be signed
and approved by the Historical
. Coordinator prior to permit Issuance.
APPROVED'
This permit Is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City. 01 Springfield, Including the
Development Code, regulating the'.constructlon and use of
buildings, and-may be suspended or revoked at any time
upon violation of any provisions o(sald ordinances,
?~-~
Plan Check Fee'
Date Paid:
Receipt Number.
Received By:
//?~
PJIln'j)'fOvieweiJ By
~\/~-'3~
Date
Systems Development Charge Is due on all undeveloped
properties within tho City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that J have carefully examlneej
the completed application and do hereby certify that aU
information hereon Is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinances of lhe City of Springfield, and the Laws
of the" State of Oregon pertaining to tho work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the BuildIng Safety DivisIon,
I further certify that only contractors and employees who
are In compliance with GRS 701.055 will be used on thIs
project.
I further agree to ensure that all required Inspections are
requested at t.he proper time; that each address Is readable
from the street, that the permit card Is located at the front
of the property, and the approved set of plans will remain
on the site at a lmes during nstr ctlon,
Date
Signature
VAliDATION:
RECEIPT NUMBER 2t::::.?6 ~
DATE PAID L-/Z-5?
AMOUNT RECEIVED--6~ .lG.::L
RECEIVED BY ~ ~